Causes of infertility in men
SO WHAT HAPPENS IF YOU DECIDE
TO GO FOR TREATMENT?
First of all your GP or family planning nurse will
Penis want to find out if there is any reason why you
• Problems with ejaculation, or aren’t getting pregnant. They will check whether
you have had any previous illnesses or operations,
whether either of you have any problems, such as
irregular periods for the woman, and how often
and at what time of the month you have sex. The
questions can be embarrassing, but it is essential
WHEN YOU DON’T GET PREGNANT Testes to check that there isn’t a simple explanation for
If you have decided you want a baby then not • Low sperm count, which may be the problem. Some people may just not be having
getting pregnant can be devastating. But it is the result of hormonal problems of sex at the most fertile time of the woman’s cycle.
surprisingly common. One in seven couples are previous illnesses such as mumps,
or a number of other reasons like The next step is some simple tests. For the woman
affected by infertility at some point in their lives, there are blood and urine tests to check that
smoking and too much heat.
but the good news is that even those who have • Poor quality sperm, which are not ovulation has taken place. For men there is a
not conceived for three years, the likelihood of strong enough to swim up into the semen analysis to check the quality, quantity and
getting pregnant in the end is 25%. woman’s fallopian tubes. • Previous vasectomy. mobility of sperm. The family planning clinic can
• Enlarged veins within the testes, • Blocked tubes from an infection. also do a postcoital check, where 12 hours after
Fertility treatment has made great progress and called ‘varicocoele’, which prevent
there are now many options available. We answer making love the mucus in the woman’s vagina is
the sperm from passing through. checked for live healthy sperm.
some common questions.
Other investigations are ultrasound and
WHY CAN’T I GET PREGNANT? But very often there is no particular reason why a WHEN SHOULD WE GO FOR HELP? laparoscopy – a procedure where a small camera
It is an emotional thing when you don’t get couple may be having difficulty in conceiving. It This depends on how you feel, but 85% of couples is used to see what is going on inside your body.
pregnant. Very often people blame themselves and could be due to stress or just a question of time. will normally conceive after one year, it is a good Finally, if there is still no sign of a pregnancy, the
think it is their fault. Women can feel guilty and When all the investigations have been done and idea to seek help after twelve months. There may couple may then want to consider fertility
think, ‘I’m not a proper woman if I can’t have a there is nothing obviously wrong physically with be a reason why you are not conceiving which can treatment, or ‘assisted conception’.
baby’. For men it can be particularly hard, either the man or the woman, it is called be treated. Visit your GP or your local family
especially if the reason for the infertility is because ‘unexplained infertility’. planning clinic.
of them – a low sperm count for example. Often
couples find it difficult to admit that there is a
problem and don’t go for treatment. But there can
be lots of reasons for infertility, many of which can
be treated with great success.
Q We have found out that the reasonsperm count is low.
pregnant is because my partner’s
I’m not getting feel he is a failure because he can’t get you pregnant. It
might be a good idea to take a break from baby making
Now he has completely gone off sex. Is this normal? and to spend time doing things together that you both
A It is not unusual for couples to find baby making stressful.
Making love can become clinical and your partner may
enjoy, to remind you why you wanted to be together in
the first place.
Causes of infertility in women Fertility treatment
Q I’ve readhave iftwins or triplets.you this more Q My partner was married before and had 3are Q After we’d been trying for a baby for
that you have IVF
true? children and then a vasectomy. Now we eighteen months I went to the doctor. He
• May not be producing eggs. This could be for a number of
• May be blocked because of a previous infection or
A the womb. Because the treatment involved in
IVF involves replacing fertilised embryos into together we want to have a baby of our
own. What choices do we have?
couldn’t find anything wrong with me and
says he needs to see my husband. But he
reasons for example polycystic ovary syndrome (PCOS). operations, so that the sperm cannot get through
creating live embryos is long and hard for the
A If not then you might want to consider this as
Has your partner had his vasectomy reversed? refuses to go.
• The eggs may not be released.
• There may be damage from ‘endometriosis’ or cysts.
to meet the egg. couple, and unfortunately there is a risk that
the embryos may still die once implanted, the a first step. It is a delicate operation, which A A good start maythe firstexplain to the doctor
husband that in
doctors try to increase the chances of a involves unblocking the tube which carries the will probably just want to check out his overall
pregnancy by implanting several embryos at sperm from the testicles to the penis. He health. This does not mean giving a semen
the same time. The authorities recommend would have to have an anaesthetic and would sample there and then as this is usually
that only two embryos are implanted, but in need to stay in hospital for a day or so, but carried out at assisted conception clinics. In
some circumstances they may allow three. there is a 30–70% chance that he would then some cases, men can make quite small
This obviously increases the chances of produce sperm as normal. Your second option changes to their lifestyles and improve their
Womb/uterus Cervix having a multiple birth. After discussion with is to consider using a sperm donor (DI or sperm count. If your husband still refuses, you
• May be an abnormal shape, so the egg cannot implant itself • May be partly opened so that infection gets in and the doctor you will be given the choice of how donor insemination). This would involve using may need to talk about your feelings as in the
and grow. damages the embryo. many embryos are reimplanted, up to the sperm that was not your partner’s to make you long term his refusal is likely to create tension
• May contain fibroids or polyps, (growths inside the womb), • May produce hostile mucus that kills the sperm as maximum of three. pregnant. You might want to discuss this and resentment in your relationship.
which prevent the egg from attaching itself. they try to swim through to fertilise the egg. option very carefully with your partner before
taking it because he would not be the natural
father of the baby.
What are the options for For Men
fer tility trea tment? Treatment
How it works
Tablets or injections to increase the activity
of the testes.
What it means for you
Unfortunately the evidence suggests that drug treatment
for men is not very effective.
Varicocele This is a short operation where the blocked This is a short and painless operation so is worth
Our quick guide gives you a summary of information, though your treatment vein in the testicle is tied off or removed with trying as some men have an improved sperm
assisted conception unit or fertility clinic will be able to provide you with a chemical injection. count afterwards.
information to meet your own needs. Reversing a A delicate operation where the tiny narrow The success rate varies from 35% to 71%.
vasectomy tube from the testes to the penis is unblocked.
For Women Assisted conception
Treatment How it works What it means for you Treatment How it works What it means for you
Fertility pills Tablets for 5 days in each monthly cycle to This treatment has a 65% success rate if the periods are IUI (Intrauterine Specially selected and washed sperm are This method can be successful when there are problems
‘Clomiphene’ make the ovaries produce eggs regularly. restored. insemination) placed into the partner’s womb using fine with the cervix or the man’s sperm quality.
plastic tubing. The woman usually takes
HMG injections Injections from the beginning of the cycle until Has to be carefully monitored by your doctor. There is a fertility drugs beforehand.
just before ovulation to improve egg higher risk of twins or triplets.
production. This treatment is used as part DI (Donor This is when sperm from a donor is put into a Although the chances of a pregnancy are high, this needs
of IVF. insemination) woman’s vagina or womb. It is offered to careful thinking about beforehand, because the woman’s
couples if the man has very few sperm, or partner will not be the baby’s natural father.
Pump therapy Giving hormones through a pump worn on the This is a good way to give hormones, because the pump has had a vasectomy, or carries an
arm to make the ovaries produce eggs. mimics the body. inherited disease.
Nasal spray A spray into the nose every 4 hours. This slows Particularly good for treating polycystic ovaries in IVF (‘in vitro This is where an egg is taken from the woman, This is now a widely used procedure and has a one in
‘Buselin’ down the ovaries so they respond better preparation for IVF. fertilisation’ or fertilised with her partner’s sperm in a test five chance of success each time it is tried. However it
to HMG injections. test tube tube and replanted into her womb. can be a lengthy and traumatic process for the couple.
Treatment for This is done using drugs or microsurgery. The success rate is variable so the surgery is only
endometriosis recommended when the condition is severe. GIFT (gamete Newer than IVF, this treatment involves taking This is an alternative to IVF, which is sometimes
intrafallopian eggs from the ovaries, mixing them with used when there is no obvious reason for the infertility.
Tubal surgery This involves operating on blocked or scarred Although the results won’t be immediate, there is a 60% transfer) the partner’s sperm and immediately
fallopian tubes to open them up. chance of conception after the operation, depending replacing them into the fallopian tubes
on the nature and extent of the tubal damage. before fertilisation has taken place.
Operating on the This can be a major operation to remove There is a 65% to 75% chance of getting pregnant after ICSI A relatively new treatment, this is where an This treatment has worked when IVF has failed and when
uterus (womb) fibroids or open up the cavity in the uterus. successful surgery on the womb. (intracytoplasmic individual’s sperm, which has been specially the man has a low sperm count. It offers another chance
sperm injection) prepared, is injected directly into the partner’s to couples who have been through all the other
egg. It is done to bypass any barriers to treatments.
conception, such as blocked tubes.